Abstract:
OBJECTIVES:To describe the natural course of distant metastases (DMs) following radiotherapy (RT) or chemoradiotherapy (CRT) in HPV(+) oropharyngeal carcinoma (OPC). METHODS:OPC treated with RT/CRT from 1/1/2000 to 5/31/2010 were reviewed. The natural course of DM were compared between HPV(+) and HPV(-) cohorts. RESULTS:Median follow-up was 3.9 years. The DM rate were similar (11% vs. 15% at 3-years, p=0.25) between the HPV(+) (n=457) vs. the HPV(-) (n=167) cases. While almost all (24/25) HPV(-) DM occurred within 2-years following RT (1 was at 2.1 years), 7/54 (13%) of HPV(+) DM were detected beyond 3 years (up to 5.3 years). Disseminating to >2 organs occurred in 18 (33%) HPV(+) vs. none in HPV(-). Post-DM survival rates were 11% vs. 4% at 2-years (p=0.02) for the HPV(+) vs. HPV(-) cases respectively. 5/6 HPV(+) with lung oligo-metastasis were still alive with stable disease beyond 2-years after salvage procedures for DM (chemotherapy: 3; surgical resection: 2; radiotherapy: 1). CONCLUSIONS:Although DM rates are similar, the natural course of HPV(+) DM differs from that of HPV(-) patients: it may occur after a longer interval, often with a "disseminating" phenotype, and a small number may have prolonged survival after salvage for DM.
journal_name
Oral Oncoljournal_title
Oral oncologyauthors
Huang SH,Perez-Ordonez B,Weinreb I,Hope A,Massey C,Waldron JN,Kim J,Bayley AJ,Cummings B,Cho BC,Ringash J,Dawson LA,Siu LL,Chen E,Irish J,Gullane P,Hui A,Liu FF,Shen X,Xu W,O'Sullivan Bdoi
10.1016/j.oraloncology.2012.07.015subject
Has Abstractpub_date
2013-01-01 00:00:00pages
79-85issue
1eissn
1368-8375issn
1879-0593pii
S1368-8375(12)00243-6journal_volume
49pub_type
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